Chronic Obstructive Pulmonary Disease (COPD) is chronic lung conditions which causes increasing shortness of breath, cough and other symptoms. It includes emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. Many people mistake their increased breathlessness and coughing as a normal part of aging. In the early stages of the disease, you may not notice the symptoms. COPD can develop for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease. That’s why it is important that you talk to your doctor as soon as you notice any of these symptoms.
Common sign and symptoms of COPD
- Increased breathlessness, Frequent coughing (with and without sputum)
- Wheezing, Tightness in the chest
How is COPD diagnosed?
- Once clinical symptoms indicate possible COPD, your physician may order spirometry or pulmonary function test, to measure lung capacity, to confirm the diagnosis.
How common is COPD?
COPD affects an estimated 24 million individuals in the U.S., and over half of them have symptomsof COPD and do not know it. Early screening can identify COPD before major loss of lung function occurs.
What are the risk factors and common causes of COPD?
Most cases of COPD are caused by inhaling pollutants; that includes smoking (cigarettes, pipes, cigars, etc.), and second-hand smoke.Fumes, chemicals and dust found in many work environments are contributing factors for many individuals who develop COPD.Genetics can also play a role in an individual’s development of COPD—even if the person has never smoked or has ever been exposed to strong lung irritants in the workplace.
COPD most often occurs in people 40 years of age and older who have a history of smoking. These may be individuals who are current or former smokers. While not everybody who smokes gets COPD, most of the individuals who have COPD (about 90% of them) have smoked.
COPD can also occur in those who have had long-term contact with harmful pollutants in the workplace. Some of these harmful lung irritants include certain chemicals, dust, or fumes. Heavy or long-term contact with secondhand smoke or other lung irritants in the home, such as organic cooking fuel, may also cause COPD.
Even if an individual has never smoked or been exposed to pollutants for an extended period of time, they can still develop COPD. Alpha-1 Antitrypsin Deficiency (AATD) is the most commonly known genetic risk factor for emphysema2. Alpha-1 Antitrypsin related COPD is caused by a deficiency of the Alpha-1 Antitrypsin protein in the bloodstream. Without the Alpha-1 Antitrypsin protein, white blood cells begin to harm the lungs and lung deterioration occurs. The World Health Organization and the American Thoracic Society recommends that every individual diagnosed with COPD be tested for Alpha-1. For more information about AATD
How Is COPD Treated?
COPD has no cure yet. However, lifestyle changes and treatments can help you feel better, stay more active, and slow the progress of the disease.
The goals of COPD treatment include:
- Relieving your symptoms
- Slowing the progress of the disease
- Improving your exercise tolerance (your ability to stay active)
- Preventing and treating complications
- Improving your overall health
To assist with your treatment, your family doctor may advise you to see a pulmonologist. This is a doctor who specializes in treating lung disorders.
Quit Smoking and Avoid Lung Irritants
Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and products that can help you quit.
Bronchodilators relax the muscles around your airways. This helps open your airways and makes breathing easier.
Depending on the severity of your COPD, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators last about 4–6 hours and should be used only when needed. Long-acting bronchodilators last about 12 hours or more and are used every day.
Most bronchodilators are taken using a device called an inhaler. This device allows the medicine to go straight to your lungs. Not all inhalers are used the same way. Ask your health care team to show you the correct way to use your inhaler.
If your COPD is mild, your doctor may only prescribe a short-acting inhaled bronchodilator. In this case, you may use the medicine only when symptoms occur.
If your COPD is moderate or severe, your doctor may prescribe regular treatment with short- and long-acting bronchodilators.
Combination Bronchodilators plus Inhaled Glucocorticosteroids (Steroids)
If your COPD is more severe, or if your symptoms flare up often, your doctor may prescribe a combination of medicines that includes a bronchodilator and an inhaled steroid. Steroids help reduce airway inflammation.
In general, using inhaled steroids alone is not a preferred treatment.
Your doctor may ask you to try inhaled steroids with the bronchodilator for a trial period of 6 weeks to 3 months to see whether the addition of the steroid helps relieve your breathing problems.
The flu (influenza) can cause serious problems for people who have COPD. Flu shots can reduce your risk of getting the flu. Talk with your doctor about getting a yearly flu shot.
This vaccine lowers your risk for pneumococcal pneumonia (NU-mo-KOK-al nu-MO-ne-ah) and its complications. People who have COPD are at higher risk for pneumonia than people who don’t have COPD. Talk with your doctor about whether you should get this vaccine.
Pulmonary rehabilitation (rehab) is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems.
Rehab may include an exercise program, disease management training, and nutritional and psychological counseling. The program’s goal is to help you stay active and carry out your daily activities.
Your rehab team may include doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians. These health professionals will create a program that meets your needs.
If you have severe COPD and low levels of oxygen in your blood, oxygen therapy can help you breathe better. For this treatment, you’re given oxygen through nasal prongs or a mask.
You may need extra oxygen all the time or only at certain times. For some people who have severe COPD, using extra oxygen for most of the day can help them:
- Do tasks or activities, while having fewer symptoms
- Protect their hearts and other organs from damage
- Sleep more during the night and improve alertness during the day
- Live longer
Surgery may benefit some people who have COPD. Surgery usually is a last resort for people who have severe symptoms that have not improved from taking medicines.
Surgeries for people who have COPD that’s mainly related to emphysema include bullectomy (bul-EK-toe-me) and lung volume reduction surgery (LVRS). A lung transplant might be an option for people who have very severe COPD.